Archived: Allied Healthcare Brighton & Hove

Updated 2 June 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 25 April 2017 and was announced. This was so that key people could be available to participate in the inspection. Two inspectors undertook the inspection, with an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, we reviewed information we held about the service. This included previous inspection reports, complaints and any notifications. A notification is information about important events which the service is required to send us by law. The provider was asked to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We contacted the local authority commissioning teams, who have responsibility for monitoring the quality and safety of the service provided to local authority funded people. We received feedback from a social care professional about their experiences of the service provided.

We spoke with 17 people using the service, and two relatives. We spoke with the operations manager, the care delivery manager, two care quality supervisors, 11 care staff and a coordinator. We spent time reviewing the records of the service, including policies and procedures, 10 people’s care and support plans, the recruitment records for three new care staff, complaints recording, accident/incident and safeguarding recording, and staff rotas. We also looked at the provider’s quality assurance audits.

Updated 2 June 2017

Allied Healthcare Brighton & Hove is a domiciliary care agency providing personal care for a range of people living in their own homes. These included people with dementia, older people, people with a physical disability or learning disability, and people who have an eating disorder, or misuse drugs and alcohol. At the time of our visit around 186 people were receiving a service.

At the last inspection on 15 July 2014, the service was rated Good. At this inspection we found the service remained overall Good. However, we did find some areas of practice which needed improvement which had not been consistently maintained. This was in relation to the maintenance of the review of people’s care and support plans. People told us there was not always good communication when there were changes to the times care was provided. These are areas in need of improvement.

Staff spoke of a difficult period since the last inspection where another two of the provider’s care at home services had been merged in with Allied Healthcare (Brighton and Hove.) This meant the service now covered East and West Sussex as well as Brighton and Hove. Staff we spoke with were at different stages of working through this process. Paperwork being used was not consistent and at times difficult to navigate through. They told us staffing changes had led to some delay in reviewing care and support plans, but senior staff demonstrated a robust action plan they had followed to address these issues.

Systems had been maintained to keep people safe. People and their relatives told us they felt people were safe with the care provided. They knew who they could talk with if they had any concerns. They felt they could raise concerns and they would be listened to. Assessments of risks to people had been developed. Robust recruitment practices continued to be followed to ensure enough staff had been recruited to meet people’s care and support needs. Staff told us they had continued to receive supervision, and be supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. One member of staff told us they had, “Regular supervision and supervisor will come and check work on spot checks.”

People's individual care and support needs had been identified before they received a service. Care and support provided was personalised and based on the identified needs of each individual. Detailed care and support plans were in place. Where people were unable to make decisions for themselves this had been considered under the Mental Capacity Act 2005, and appropriate actions continued to be followed to arrange meetings to make a decision within their best interests. Staff had a good understanding of consent. One member of staff told us when they provided care they, “Always ask even if routine.” A relative told us, “They will encourage him to turn over onto his side by himself, so that they can apply his creams, I hear them telling him what they are doing and saying is that ok.”

People were supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. One person told us, “Yes I am quite happy with everything, they are kind and gentle with me.” Another person told us, “They are absolute angels I would not want to change a thing.” A third person said, “All very kind and caring I have no complaints.”

If needed, people were supported with their food and drink and this was monitored regularly. One person told us, “I’ve got a list of my food in the freezer, I discuss it with them and choose daily and they cook it for me.” One member of staff said when they supported people with their food and fluid intake they would try a, “Different approach and make sure likes and dislikes catered for.” A further member of staff told us they would, “Make food they like. Nice presentation. If weight loss or poor appetite will give choice of foods and call office.”

People continued to be supported to maintain good health. One person told us, “If I am feeling unwell I let them know like now I have a sore tendon, they will check how I am and write it in the book.” Another person told us, “They noticed that I had a sore leg and called the doctor.” A third person said, “If I feel unwell they will call a

Doctor or we discuss what to do.”

People and staff told us the service was well led. Senior staff carried out a range of internal audits, and records confirmed this. People and their relatives were regularly consulted by the provider about the care provided.

Further information is in the detailed findings below.